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Obstructive Sleep Apnea and Multiple Sclerosis (MS)

Fatigue is one of the most common as well as most debilitating symptoms of Multiple Sclerosis (MS). Experienced by over 80% of MS patients, fatigue and the way it hinders your ability to function at work and at home, is a major contributor to MS patients leaving their job and career. But obstructive sleep apnea and multiple sclerosis and its fatigue can be linked.

Fatigue amongst MS patients has commonly been attributed to depression, nocturnal muscle spasms, or bladder dysfunction — other common MS symptoms. But, new studies show that Obstructive Sleep Apnea (OSA) is highly prevalent amongst MS patients and may be a major contributor to the fatigue that they are experiencing.

The Prevalence of Sleep Apnea in Multiple Sclerosis Patients

The Multiple Sclerosis Journal published a study in 2011 evaluating the relationship between Obstructive Sleep Apnea (OSA) to fatigue and sleepiness in Multiple Sclerosis (MS) patients. Among the findings in this study, OSA was frequent in MS patients (twice the rate) and OSA was associated with fatigue in the MS population.

These findings have been confirmed by additional studies, including one published in 2014 by the American Academy of Sleep Medicine. In this study, researchers found that one-fifth of MS patients also suffered from OSA and over half had an elevated risk for OSA. Additionally, they found that the risk of OSA was a significant predictor of fatigue severity.

The findings from these studies mirror the results of a study I conducted years ago. MidAmerica Neuroscience Institute presented High Prevalence of Sleep Disorders in Multiple Sclerosis at the Consortium of Multiple Sclerosis Centers (CMSC) meeting in 2004. We conducted a retrospective study to determine the frequency of concurrent sleep disorders in our MS patients. We found:

1. Sleep disorders including obstructive sleep apnea (OSA) appear to be more prevalent in the MS population than has been reported in the general population, occurring in 49% of the MS patients. Epidemiological studies estimate that 2 to 5% of the general population meets the minimal diagnostic criteria for OSA, and the prevalence of Periodic limb movement disorder (PLMD) in the general population ranges from 5% in subjects 30-50 years of age, up to 44% of patients 65 and older.

2. These striking results suggest the need for screening for sleep disorders in MS patients, especially those with fatigue or cognitive difficulties.

What this means for MS Patients

Because of the multitude of symptoms and conditions that MS patients experience, we can assume that Obstructive Sleep Apnea has often been overlooked by clinicians, attributing the fatigue to other MS symptoms or conditions and/or the medications that they’re on. Consequently, OSA has often been under-recognized as contributing to MS patients’ fatigue. The failure to diagnose OSA is problematic as it’s a chronic illness that can have a very negative effect on your health. And OSA is a pro-inflammatory condition, like having a chronic infection in your body to turn on your immune system. If you have MS, you don’t want that! You’re probably taking disease modifying therapies to tone down your immune system already, so OSA is working against the effects of those medications.

If you have an MS diagnosis, don’t wait for your fatigue to worsen. Bring up the possibility of OSA with your doctor. Ask for a sleep test or a referral to a doctor who is certified in sleep medicine to conduct a proper sleep evaluation. The sleep test will be able to properly diagnose OSA as well identify its treatment. While more research is needed to determine the cause-and-effect relationships of MS and OSA, these findings increase the possibility that by treating your OSA, you could also be eliminating a large portion of the fatigue that you’re experiencing.

Nervous about the possibility of a sleep evaluation? Find out what a sleep test is and how it will help you get to the root cause of your fatigue. Read About Sleep Studies.

Get the Answers You Need

Headaches, neck pain, back pain, sleep disorders, and multiple sclerosis. As the founder and a top neurologist at a major neurology center, I have seen a lot of tough cases of each of these conditions. They’re complex and disruptive to your quality of life. But, what most don’t realize is that they can all be connected. In this guide, I dissect each of these neurological conditions and show you how the symptoms you’re experiencing may all be related.

I have created free online video series to help you better understand your symptoms and disorder and take back control of your life.

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About Dr Rowe

Dr. Vernon Rowe has dedicated his career to finding the root causes of neurologic disorders. In the process, he has explored the amazing complexity of the most complex system in the human body, the nervous system, and has discovered that many of the most common problems in neurology, like headache, hypermobility, sleep problems, neck pain, and back pain are all interrelated. That really shouldn’t be a surprise, because we as human beings have a single body, and everything we do, and all parts of that body, are interconnected.

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